Acute pasteurella multocida in total knee arthroplasty (original) (raw)
Related papers
Pasteurella multocida infected total knee arthroplasty: a case report and review of the literature
Annals of the Royal College of Surgeons of England, 2014
Pasteurella multocida is a rare cause of prosthetic joint infection. This infection generally follows significant animal contact, usually licks and scratches. We report a case of P multocida infection that was treated with linezolid with salvage of the implant. Linezolid is generally active against Gram-positive organisms only with the exception of Pasteurella, which is Gram-negative. We extensively review the previous reported cases of implant infection with P multocida.
Cureus, 2023
Pasteurella multocida, a zoonotic infectious organism, has most often been described in patients after an animal bite. It can cause a variety of infections ranging from superficial skin infections to more serious systemic infections, such as sepsis and meningitis. P. multocida is a rare but well-recognized cause of prosthetic joint infections. Here, we report the first implant-associated infection caused by drug-resistant (penicillin, ampicillin, amoxicillin/clavulanic acid) P. multocida, which was cured with targeted antimicrobial treatment and debridement, exchange of mobile parts, and retention of the prosthesis. Patients undergoing arthroplasty should be informed of the risks of close contact with pets, especially in light of the worrying phenomena of drug resistance spreading among animals due to the addition of antibiotics in animal feed.
Pasteurella multocida Bacteremia and Osteomyelitis from a Diabetic Foot Ulcer
Pasteurella multocida is a gram-negative coccobacillus that causes a spectrum of illnesses. P multocida lives as commensal bacteria in the upper respiratory tracts of fowl and mammals. Infections most commonly result from cat or dog bites; however, direct inoculation via saliva has been reported. Although the majority of P. multocida infections manifest in skin and soft tissue, it may cause bacteremia with disseminated infection in an immunocompromised host. Dissemination is responsive to treatment but carries a significant mortality risk of about 30%. We present a case of a 46 year old male with type 2 diabetes mellitus, coronary artery disease and chronic kidney disease with stage 4 neuropathic heel ulcer who presented with hypothermia and chills. One day into admission, 4/4 blood culture bottles were positive for Pasteurella multocida. MRI of the foot was concerning for osteomyelitis which was confirmed via I&D. The patient did report having a dog and a cat at home, but adamantly denied any bites from either animal. Examination of his boot used for support with his foot containing the ulcer revealed extensive animal hair stuck to the boot. It was deemed likely that the route of inoculation occurred from contamination of his neuropathic ulcer from his dog's saliva, likely from a lick, for which his diabetic neuropathy may have impaired initial sensation of the contamination. The patient was treated with ampicillin-sulbactam while admitted and discharged with oral levofloxacin 6 week course for residual osteomyelitis.
Infection, 2011
Pasteurella multocida is a Gram-negative bacterium recovered from a wide variety of wild and domestic animals and has mostly been associated with infection following animal bites. We present the first reported case of a patient who developed a postoperative sternal wound infection due to P. multocida complicated by bloodstream infection. The outcome was favorable following surgical debridement and antimicrobial therapy. We also review the literature regarding P. multocida postoperative wound infections.
Pasteurella spp is the first organisms to consider in any patient who presents with a soft tissue infection following cat or dog bites. Pasteurella canis is most common isolate of dog bites, but there are no reports of pastereulla canis infection caused by sheep bite. A case of a 66 years old farmer woman with symptoms of infected left hand with wrist septic arthritis, after a lamb bite is described (the sheep was sick after a dog bite). Microbiological examination of the wrist articular liquid was performed. The specimen was both aerobic and anaerobic cultures were performed. After 24 hours, growth of smooth, greyish-white colonies was observed only on Columbia agar. Another Gram stained slide was performed from those colonies and Gram negative cocobacilli to short rod shaped morphology with bipolar staining was observed. They demonstrate positive catalase and oxidase positive reaction. The bacterium was susceptible to all tested antimicrobial agents. Although systemic forms of Pasteurella are possible, cutaneous infections from animal bites are the most common presentation. Most animal-bite injuries can be treated with oral antimicrobials on an outpatient basis, but in this case the patient needed intravenous antimicrobial aggressive therapy.
Trauma Case Reports, 2018
Pasteurella multocida can cause serious infections after dog or cat bite. We report here a rare case of hand infection caused by P. multocida consecutive to an injury by a thorn of the prickly pear. It caused an amputation of the distal phalanx of the thumb in a trisomic patient. It is about a 27-year-old man who was admitted to the hospital with swelling and intense pain of the left hand. He reported a sting by a thorn of prickly pear 15 days before. The patient was admitted to proceed with operative irrigation and debridement. The pus was collected for microbiological examination. Microscopic examination after Gram staining revealed small Gramnegative coccobacilli, associated to polymorphonuclear reaction. Culture have objectivated Pasteurella multocida. The isolated strain was susceptible to betalactamins. Patient was treated with ampicillin. Well-conducted antibiotics and repetitive local cares have not prevented local lesions from progressing to necrosis of the soft parts of the thumb and osteitis of the distal phalanx of the thumb. The patient underwent a necrosectomy and an amputation of the distal phalanx. Ampicillin was replaced by amoxicillin/clavulanic acid and after 15 days, progression was clinically and microbiologically favorable. In the case we report, since the patient does not report any exposure or contact with animals, the thorn prick is the source of infection. It was contaminated from the animal reservoir. Taking into account the monomicrobism of the infection, treatment with aminopenicillins was sufficient. Our propositus came to the hospital 15 days after the inoculation of the bacterium. This duration appears to be very late in relation to the acute character of pasteurellosis. This was probably the main reason why the local infection evolved towards osteoarticular complications. That's why, we should consider Pasteurella multocida in case of infection by inoculation, even in the absence of contact with the animals.
Pasteurella multocida osteomyelitis: An unusual case presentation
The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses
A healthy male farm employee developed an unusual infection caused by Pasteurella multocida. Atypical features included the chronic nature of the infection, the development of osteomyelitis of the tibia without direct animal inoculation, and lack of fever and leukocytosis. Radiographic appearance of P multocida osteomyelitis may be the result of osteoclast activation and can be confused with musculoskeletal tumour. P multocida infection requires a high degree of suspicion, and should be considered in cases of farm- or animal-related injuries even if there is no history of direct animal contact.
A traumatic open knee wound in a replaced knee resulting in a prosthetic joint infection
Joint diseases and related surgery, 2022
Periprosthetic joint infections (PJIs) are devastating conditions that lead to significant morbidity and mortality. The two main routes of acquiring PJIs are direct inoculation from surgery and hematogenous spread. To the best of our knowledge, there is a paucity of reported cases of a PJI resulting from direct trauma, leading to an open knee injury in a prosthetic joint. It is well established that chronic infection in arthroplasties can lead to a chronically discharging sinus, leading to soft tissue defects, which preclude the possibility of debridement and implant retention (DAIR) as an option for these patients. [1] The soft tissue compromise in this case, however, is a result of an acute traumatic process, and although the size is significantly larger compared to a non-healing and persistently draining wound of an acute PJI, the nature of such wounds are also different from a sinus tract from skin and soft tissue ulceration of a chronic PJI. [2] Knee arthroplasties are successful procedures that allow patients to return to their pre-arthritic functional levels. However, the success rates can be blemished by prosthetic joint infections, which are devastating complications that commonly render patients worse off than before the index surgery. Inoculation of the pathogens is frequently from the index surgery, or through the bloodstream. Herein, we report a case of a prosthetic joint infection by which the pathogens were most likely inoculated from direct contact, through a traumatic open knee wound occurring from a road traffic accident. Management of the infection, involving an incision & drainage with modular parts exchange, as well as the challenges with the soft tissue envelope is highlighted. At one year of follow-up, the infection seemed to be curtailed. Currently, the patient is very satisfied with the condition of his knee, which has a range of motion of 0 to 135 and his pre-morbid function has been regained. This case denotes the importance of early identification, soft tissue management, as well as a multidisciplinary approach in managing such conditions.